The most effective thing you can do for a toothache right now is take 400 mg of ibuprofen (two standard pills) together with 500 mg of acetaminophen (one extra-strength pill). This combination is recommended by the American Dental Association and works as well as prescription painkillers for most dental pain, without the risks of opioids. Beyond that first step, several home strategies can reduce your pain while you arrange to see a dentist.
The Best Over-the-Counter Pain Relief
Taking ibuprofen and acetaminophen together is more effective than either one alone. Ibuprofen reduces inflammation at the source of the pain, while acetaminophen works on pain signals in the brain. You can repeat this combination every six hours. If you can only take one, ibuprofen is generally the stronger choice for dental pain because most toothaches involve inflammation.
Numbing gels containing benzocaine (like Orajel) can provide short-term relief when applied directly to the sore area. However, these come with a serious safety warning from the FDA: benzocaine can cause a rare but life-threatening condition that reduces oxygen in the blood. Never use benzocaine products on children under 2, and follow the label directions carefully for older children and adults.
Home Remedies That Actually Help
A saltwater rinse is one of the simplest and most reliable things you can do. Mix 1 teaspoon of salt into 8 ounces of warm water and swish it around the painful area for 30 seconds before spitting it out. If that stings too much, cut the salt to half a teaspoon. The salt draws out fluid from inflamed tissue and reduces the bacteria around the tooth. You can repeat this several times a day.
A diluted hydrogen peroxide rinse is another option. Mix equal parts 3% hydrogen peroxide (the standard brown bottle from the drugstore) with water to create a 1.5% solution. Swish for 30 to 60 seconds, then spit. Don’t swallow it, and don’t rinse for more than 90 seconds.
Clove oil has a long history as a natural toothache remedy. It contains a compound called eugenol that works as an anesthetic, antibacterial, and anti-inflammatory agent all at once. To use it, put a small drop on a cotton ball and hold it against the painful tooth for a minute or two. Keep in mind that clove oil is toxic to cells in concentrated form. Repeated or heavy application can irritate or damage your gums and the soft tissue inside your mouth, so use it sparingly.
Applying a cold compress to the outside of your cheek (20 minutes on, 20 minutes off) can also help reduce swelling and dull the pain.
How to Sleep With a Toothache
Toothaches often feel worse at night, and there’s a straightforward reason for it. When you lie flat, gravity pulls more blood into your head and neck. The nerve and blood vessels inside a tooth are trapped in a tiny, rigid chamber that can’t expand. Even a small increase in blood flow raises the pressure inside that space, which is why a dull ache can turn into intense throbbing the moment you go to bed.
Propping your head up about 30 to 45 degrees (two or three pillows, or a wedge pillow) forces the heart to work harder to push blood upward, reducing pressure in the inflamed tooth. Many people notice a clear improvement. Take your ibuprofen and acetaminophen about 30 minutes before bed so the medication is working by the time you lie down, and keep a saltwater rinse on your nightstand in case you wake up.
What Your Pain Is Telling You
Not all toothaches come from the same problem, and the type of pain you’re feeling offers useful clues.
A sharp zing when you drink something cold or hot that fades within a second or two usually means the inner tissue of the tooth (the pulp) is inflamed but still salvageable. This is the kind of problem a dentist can often fix with a filling. If that same pain lingers for many seconds or comes on by itself without any trigger, the damage to the pulp is more advanced, and the tooth may need a root canal.
A deep, throbbing ache that’s extremely sensitive to pressure, especially when you tap on the tooth or bite down, points toward an abscess: an infection that has spread to the root tip or surrounding bone. Abscesses don’t resolve on their own and need professional treatment.
Pain that seems to affect several upper teeth at once, especially if it gets worse when you bend over or lean forward, may not be a tooth problem at all. Sinus infections can press on the roots of your upper back teeth because the maxillary sinuses sit directly above them. A traditional toothache is usually isolated to one tooth and often comes with swollen gums or sensitivity to temperature. Sinus-related dental pain tends to feel more diffuse, shifts with head position, and may come alongside congestion or facial pressure.
Signs You Need Immediate Care
Most toothaches can wait for a regular dental appointment within a day or two. Some cannot. Get to an emergency dentist or emergency room if you notice:
- Facial swelling that’s spreading, especially if it’s near your eye, along your jaw, or under your chin
- Fever alongside dental pain, which signals an infection that may be spreading beyond the tooth
- Difficulty swallowing or breathing, which means swelling is affecting your airway
- Uncontrolled bleeding that makes you feel lightheaded
Facial swelling paired with trouble breathing or swallowing is the most urgent scenario. A dental infection that spreads into the tissues of the neck can become dangerous quickly. Don’t wait to see if it improves on its own.
What to Avoid
A few common instincts can make a toothache worse. Placing aspirin directly on the gum tissue next to a sore tooth is an old folk remedy that causes chemical burns. Aspirin works through your bloodstream, not by contact. Avoid very hot or very cold foods and drinks if temperature triggers your pain. Chewing on the affected side puts pressure on an already irritated tooth, so eat on the opposite side.
Skip alcohol as a pain remedy. Swishing whiskey on a sore tooth might numb it briefly, but alcohol irritates open wounds and inflamed tissue, and drinking enough to dull the pain systemically creates its own problems, especially if you’re also taking acetaminophen.